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Achilles tendon Rupture: It’s a tear that occurs when the Achilles tendon is stretched too far. The Achilles tendon attaches your calf muscles to your heel bone or calcaneus. You use this tendon to jump, walk, run, and stand on the balls of your feet.
Continuous, intense physical activity, such as running and jumping, can cause painful inflammation of the Achilles tendon, known as Achilles tendonitis (or tendinitis).
There are two types of Achilles tendonitis: insertional Achilles tendonitis and non-insertional Achilles tendonitis.
Insertional Achilles tendonitis affects the lower portion of your tendon where it attaches to your heel bone.
Non-insertional Achilles tendonitis involves fibers in the middle portion of the tendon and tends to affect younger people who are active.
Symptoms of Achilles tendonitis
Symptoms include:
- discomfort or swelling in the back of your heel
- tight calf muscles
- limited range of motion when flexing your foot
- the skin on your heel seems overly warm to the touch
The main symptom of Achilles tendonitis is pain and swelling in the backside of your heel when you walk or run. Other symptoms include tight calf muscles and limited range of motion when you flex your foot.
Diagnosing Achilles tendonitis
To diagnose Achilles tendonitis, your doctor will ask you a few questions about the pain and swelling in your heel or calf. Your doctor may ask you to stand on the balls of your feet while they observe your range of motion and flexibility.
The doctor also feels around or palpates, the area directly to pinpoint where the pain and swelling are most severe.
Imaging tests may help confirm Achilles tendonitis, but you usually don’t need them. If ordered, the tests include:
- X-rays, which provide images of foot and leg bones
- MRI scans, which can detect ruptures and tissue degeneration
- ultrasounds, which can show tendon movement, related damage, and inflammation
Treating Achilles tendonitis
Many treatments are available for Achilles tendonitis, ranging from home remedies, like rest and anti-inflammatory medication, to more invasive treatments, like steroid injections, platelet-rich plasma (PRP) injections, and surgery. Your doctor might suggest:
- reducing your physical activity
- very gently stretching and later strengthening your calf muscles
- switching to a different, less strenuous sport
- icing the area after exercise or when in pain
- elevating your foot to decrease any swelling
- wearing a brace or walking boot to prevent heel movement
- going to physical therapy
- taking anti-inflammatory medication, such as aspirin or ibuprofen, for a limited time
- wearing a shoe with a built-up heel to take tension off your Achilles tendon
RICE method
The rest, ice, compression, and elevation (RICE) method is usually effective in treating Achilles tendonitis right after you’re injured. This method works in the following way:
Rest: Don’t put pressure or weight on your tendon for one to two days until you can walk on the tendon without pain. The tendon usually heals faster if no additional strain is placed on it during this time.
Your doctor may suggest that you use crutches if you need to go long distances while resting your tendon.
Ice: Put ice in a bag, wrap the bag in a cloth, and place the wrapped bag of ice against your skin. Hold the bag on your tendon for 15 to 20 minutes, then take the bag off to let the tendon warm up again. The ice usually makes inflammation or swelling go down faster.
Compression: Wrap a bandage or athletic tape around your tendon to compress the injury. You can also tie an article of clothing around this area.
This keeps the tendon from swelling too much. But don’t wrap or tie anything too tightly around your tendon, as it can limit blood flow.
Elevation: Raise your foot above the level of your chest. Because your foot is higher than your heart, blood returns to the heart and keeps the swelling down. This is easiest to do by lying down and putting your foot on a pillow or other raised surface.
Surgery
In a case where this treatment isn’t sufficient, surgery may be necessary to repair your Achilles tendon. If the condition worsens and is left untreated, there’s a greater risk of an Achilles rupture, which requires surgical intervention. This can cause sharp pain in the heel area.
EXERCISES
1. Runner’s stretch
When the Achilles tendon is inflamed, it can tighten and cause discomfort. The runner’s stretch, or calf stretch, will provide relief by loosening the tendon.
To do this exercise, you’ll need a wall or other support, such as a chair.
- Place your hands on the wall or chair. If using a wall, put your hands at eye level.
- Step the leg you want to stretch behind you. Keep your back heel on the floor and point your toes straight ahead.
- Bend your other knee toward the wall, keeping your back leg straight.
- Lean toward the wall until you feel a gentle stretch in your calf. Don’t lean so far that you feel pain.
- Hold for 30 seconds—complete 3 reps.
If it hurts to straighten your leg, try a runner’s stretch with bent knees. Start closer to the wall and bend your back knee until you feel a stretch. Hold for 30 seconds and repeat three times.
2. Toe-to-wall stretch
The toe-to-wall stretch is ideal if the runner’s stretch makes your shoulders uncomfortable. It places less pressure on the upper body. Like the runner’s stretch, this exercise helps mobility by reducing stress on the Achilles tendon.
Follow these steps with the leg that’s causing discomfort.
- Stand facing the wall and place your toes up and against the wall. The higher you place your toes, the deeper the stretch.
- Lean forward, keeping your heel on the floor. (Your other leg is behind you, toes forward and heel on the ground.)
- Hold for 30 seconds—complete 3 reps.
3. Heel drop
Another Achilles tendon stretch is the heel drop. You can do it on a staircase or stepladder. If you want to use a stepladder, make sure it’s locked in position.
Do this stretch with the leg that has an Achilles tendon issue.
- Hold on to the railings of the staircase or ladder.
- Put the ball of your foot on the edge of the bottom step.
- Let your heel drop down, allowing your other foot to relax.
- Hold for 30 seconds. Complete 3 reps.
STRENGTHNING EXERCISES
1. Seated heel raises
During seated heel raises, the muscles in your calves work together to lift your heel. This improves strength and provides support for the Achilles tendon.
- Sit on a chair or at the edge of a bed. Place your feet shoulder-width apart.
- Lift your heels as high as possible, pause, then slowly lower them.
- Complete one set of 20 to 25 reps. Repeat 5 to 6 times each day.
2. Standing heel raises
If it feels comfortable, you can do heel raises while standing up. This variation also engages the muscles attached to your Achilles tendon.
- Stand with your feet shoulder-width apart. Hold on to a chair or counter top for support.
- Lift your heels and rise onto the balls of your feet. Pause, then slowly lower your heels.
- Complete one set of 20 to 25 reps. Repeat up to 5 or 6 times each day.
3. Resistance band calf exercise
You can also use a resistance band to tone your calf and heel muscles. This exercise strengthens these muscles by forcing them to work against resistance.
Start with a light resistance band. As your tendon gets stronger, you can use a thicker band with more resistance.
- Sit on the floor or on a bed. Extend your legs straight out in front of you.
- Wrap a resistance band around the ball of the foot you want to stretch, bending your knee slightly. Hold the ends with your hands.
- Pull the band to flex your foot toward you.
- Pause, release, and point your foot away from you.
- Complete 3 sets of 10 to 15 reps.
